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Author: Admin | 2025-04-28
Troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity. Methylprednisolone may increase the clearance of chronic high-dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia. The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulants when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect. Information for the Patient Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles. Patients should also be advised that if they are exposed, medical advice should be sought without delay. Adverse Reactions/Side Effects Fluid and Electrolyte Disturbances • Sodium retention • Congestive heart failure in susceptible patients • Hypertension • Fluid retention • Potassium loss • Hypokalemic alkalosis Musculoskeletal • Muscle weakness • Loss of muscle mass • Steroid myopathy • Osteoporosis • Tendon rupture, particularly of the Achilles tendon • Vertebral compression fractures • Aseptic necrosis of femoral and humeral heads • Pathologic fracture of long bones Gastrointestinal • Peptic ulcer with possible perforation and hemorrhage • Pancreatitis • Abdominal distention • Ulcerative esophagitis Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT), and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome, and reversible upon discontinuation. Dermatologic • Impaired wound healing • Petechiae and ecchymoses • May suppress reactions to skin tests • Thin fragile skin • Facial erythema • Increased sweating Neurological • Increased intracranial pressure with papilledema (pseudo-tumor cerebri), usually after treatment • Convulsions • Vertigo • Headache Endocrine • Development of Cushingoid state • Suppression of growth in children • Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery, or illness • Menstrual irregularities • Decreased carbohydrate tolerance • Manifestations of latent diabetes mellitus • Increased requirements of insulin or oral hypoglycemic agents in diabetics Ophthalmic • Posterior subcapsular cataracts • Increased intraocular pressure • Glaucoma • Exophthalmos Metabolic • Negative nitrogen balance due to protein catabolism The following additional reactions have been reported following oral as well as parenteral therapy: Urticaria and other allergic, anaphylactic, or hypersensitivity reactions. Methylprednisolone Tablets Dosage and Administration The initial dosage of methylprednisolone tablets may vary from 4 mg to 48 mg of methylprednisolone per day, depending on the specific disease entity being treated. In situations of less severity, lower doses will generally suffice, while in selected patients,
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